Individual provider Active NPI

Libby Kathleen Larson Judy, D.C.

  • Chiropractor
  • Hopkins, MN
National Provider Identifier
1841448727
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5137 Issued in MN
Practice address
10417 Excelsior Blvd
Ste 3
Hopkins, MN 55343-3440
Phone
(952) 922-8895
Fax
(952) 922-8498
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5137 MN Primary

Addresses

Primary practice location

10417 Excelsior Blvd
Ste 3
Hopkins, MN 55343-3440

Mailing address

7204 W 27TH St
Suite 110
Saint Louis Park, MN 55426-3157
Phone (612) 578-7233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212001204 MN Practitioner - Chiropractic 5698961936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10417 Excelsior Blvd
Suite 3
Hopkins, MN 55343-3440
Phone (952) 922-8895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5137MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Touch of Health Wellness Center, LLC CurrentSince Nov 7, 2016 Accepting new patients
Complex Cares LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

10417 Excelsior Blvd
Ste 3
Hopkins, MN 55343
Phone (651) 756-9595

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1841448727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7204 W 27TH ST",
            "address_2": "SUITE 110",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554263157",
            "telephone_number": "612-578-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10417 EXCELSIOR BLVD",
            "address_2": "STE 3",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553433440",
            "telephone_number": "952-922-8895",
            "fax_number": "952-922-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON JUDY",
        "first_name": "LIBBY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkins, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.